Behavioural Observation

• Document No.

• Audit Title

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Observation Team

• Duration

Observations

• In then line of fire

• Caught in, on or between

  Safe

  At Risk

  N/A

• In the path of machinery

  Safe

  At Risk

  N/A

• Communication

• Use of radio / hand signals

  Safe

  At Risk

  N/A

• Identifying potential hazards

  Safe

  At Risk

  N/A

• Work permits

  Safe

  At Risk

  N/A

• Adequate

  Safe

  At Risk

  N/A

• Understood

  Safe

  At Risk

  N/A

• TRA / JSA / Prestart followed

  Safe

  At Risk

  N/A

• Controlled physical movement

• Lifting or moving

  Safe

  At Risk

  N/A

• Repetitive movements

  Safe

  At Risk

  N/A

• Access Area

• Housekeeping & Layout

  Safe

  At Risk

  N/A

• Securing equipment

  Safe

  At Risk

  N/A

• Barricade & Signage

  Safe

  At Risk

  N/A

• Work permits

  Safe

  At Risk

  N/A

• Tools and PPE selection

• Condition of tools

  Safe

  At Risk

  N/A

• Availability of tools

  Safe

  At Risk

  N/A

• Use of correct PPE

  Safe

  At Risk

  N/A

• Vehicles and machinery

  Safe

  At Risk

  N/A

• Electrical hazards

  Safe

  At Risk

  N/A

• Other energy sources

  Safe

  At Risk

  N/A

• Hazardous substances

  Safe

  At Risk

  N/A

• Eyes on path

• Exerting or rushing

  Safe

  At Risk

  N/A

• Ascending or descending

  Safe

  At Risk

  N/A

• Look before moving

• Clear access

  Safe

  At Risk

  N/A

• Spotters

  Safe

  At Risk

  N/A

• Trip Hazards

  Safe

  At Risk

  N/A

Safe and at risk behaviours observed

• Picture of behaviours

  Media

Action taken, Discussions held

Future actions

• Actions - Assigned Person - Date Due

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